When meconium is present in the amniotic fluid of an infant during a delivery, there is a likelihood that this meconium will enter the airway of the newborn infant resulting in asphyxia. Asphyxia lowers blood oxygen content (hypoxemia) with a resulting fall in pH (acidosis). As long as decreased pulmonary function exists, proper oxygenation of the newborn's body tissues is impossible.
The recommended procedure during a birth is to immediately view the trachea after delivery with a laryngoscope. If thick or particulate meconium-stained fluid is present, it is extremely important to suction the fluid from the newborn as soon as possible. Asphyxia can be prevented by quickly and properly suctioning the infant and then ventilating the infant with 100% oxygen. Currently available aspirating and ventilating apparatus for newborn infants have several deficiencies.
In the recommended procedure, a conventional type endotracheal tube is shortened with a scissors and connected with a coupling to a bulky adapter. The bulky adapter is used to regulate the vacuum in the endotracheal tube and to connect the endotracheal tube via a line to a vacuum source. The vacuum source is generally a regulated wall unit.
The endotracheal tube is inserted in the trachea of a newborn infant approximately 3 cm. below the vocal chords and continuous suction is applied to remove meconium from the trachea.
After suctioning, the endotracheal tube coupling may be disconnected from the bulky adapter and a ventilating device attached to the endotracheal tube to oxygenate an asphyxiated infant.
One deficiency of the recommended practice is that the endotracheal tube is difficult to maneuver because of the bulk of the adapter and the closeness of the line from a wall vacuum source to a physician's wrist. The closeness of the line from the vacuum source imposes a load on the physician's wrist which must be overcome when maneuvering the endotracheal tube.
Another deficiency is that the endotracheal tube coupling is difficult to disconnect from the bulky adapter when it is necessary to connect a ventilating device. A third deficiency is that the apparatus has three connections between the endotracheal tube and wall vacuum source. The three connections consume time during a setting up of the apparatus and increase the likelihood of an accidental detachment of the endotracheal tube from the wall vacuum source.
A fourth deficiency is that time is required for shortening the endotracheal tube and connecting and disconnecting the endotracheal tube from the coupling and the coupling from the adapter.
A fifth deficiency is that suctioning is a two-handed operation because of the distance between the endotracheal tube and the suction regulating port.